EP2796880A1 - Typage allo-antigène plaquettaire et tests d'anticorps plaquettaire - Google Patents

Typage allo-antigène plaquettaire et tests d'anticorps plaquettaire Download PDF

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Publication number
EP2796880A1
EP2796880A1 EP20130002263 EP13002263A EP2796880A1 EP 2796880 A1 EP2796880 A1 EP 2796880A1 EP 20130002263 EP20130002263 EP 20130002263 EP 13002263 A EP13002263 A EP 13002263A EP 2796880 A1 EP2796880 A1 EP 2796880A1
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EP
European Patent Office
Prior art keywords
hpa
antibody
platelet
platelets
human
Prior art date
Legal status (The legal status is an assumption and is not a legal conclusion. Google has not performed a legal analysis and makes no representation as to the accuracy of the status listed.)
Granted
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EP20130002263
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German (de)
English (en)
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EP2796880B1 (fr
Inventor
Manfred Schawaller
Claudio Rhyner
Cezmi Akdis
Max Wiki
Reto Crameri
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DAVOS DIAGNOSTICS AG
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Davos Diagnostics AG
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Publication date
Priority to NO14001772A priority Critical patent/NO2796881T3/no
Priority to EP13002263.5A priority patent/EP2796880B1/fr
Priority to ES14001772.4T priority patent/ES2657236T3/es
Priority to DK14001772.4T priority patent/DK2796881T3/en
Application filed by Davos Diagnostics AG filed Critical Davos Diagnostics AG
Priority to ES13002263.5T priority patent/ES2610731T3/es
Priority to DK13002263.5T priority patent/DK2796880T3/en
Priority to EP14001772.4A priority patent/EP2796881B1/fr
Priority to PCT/EP2014/001110 priority patent/WO2014173546A2/fr
Priority to JP2016509327A priority patent/JP2016524691A/ja
Priority to US14/787,046 priority patent/US20160077089A1/en
Publication of EP2796880A1 publication Critical patent/EP2796880A1/fr
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    • GPHYSICS
    • G01MEASURING; TESTING
    • G01NINVESTIGATING OR ANALYSING MATERIALS BY DETERMINING THEIR CHEMICAL OR PHYSICAL PROPERTIES
    • G01N33/00Investigating or analysing materials by specific methods not covered by groups G01N1/00 - G01N31/00
    • G01N33/48Biological material, e.g. blood, urine; Haemocytometers
    • G01N33/50Chemical analysis of biological material, e.g. blood, urine; Testing involving biospecific ligand binding methods; Immunological testing
    • G01N33/53Immunoassay; Biospecific binding assay; Materials therefor
    • G01N33/543Immunoassay; Biospecific binding assay; Materials therefor with an insoluble carrier for immobilising immunochemicals
    • G01N33/54306Solid-phase reaction mechanisms
    • GPHYSICS
    • G01MEASURING; TESTING
    • G01NINVESTIGATING OR ANALYSING MATERIALS BY DETERMINING THEIR CHEMICAL OR PHYSICAL PROPERTIES
    • G01N33/00Investigating or analysing materials by specific methods not covered by groups G01N1/00 - G01N31/00
    • G01N33/48Biological material, e.g. blood, urine; Haemocytometers
    • G01N33/50Chemical analysis of biological material, e.g. blood, urine; Testing involving biospecific ligand binding methods; Immunological testing
    • G01N33/86Chemical analysis of biological material, e.g. blood, urine; Testing involving biospecific ligand binding methods; Immunological testing involving blood coagulating time or factors, or their receptors
    • GPHYSICS
    • G01MEASURING; TESTING
    • G01NINVESTIGATING OR ANALYSING MATERIALS BY DETERMINING THEIR CHEMICAL OR PHYSICAL PROPERTIES
    • G01N33/00Investigating or analysing materials by specific methods not covered by groups G01N1/00 - G01N31/00
    • G01N33/48Biological material, e.g. blood, urine; Haemocytometers
    • G01N33/50Chemical analysis of biological material, e.g. blood, urine; Testing involving biospecific ligand binding methods; Immunological testing
    • G01N33/53Immunoassay; Biospecific binding assay; Materials therefor
    • G01N33/543Immunoassay; Biospecific binding assay; Materials therefor with an insoluble carrier for immobilising immunochemicals
    • G01N33/54366Apparatus specially adapted for solid-phase testing
    • G01N33/54373Apparatus specially adapted for solid-phase testing involving physiochemical end-point determination, e.g. wave-guides, FETS, gratings
    • GPHYSICS
    • G01MEASURING; TESTING
    • G01NINVESTIGATING OR ANALYSING MATERIALS BY DETERMINING THEIR CHEMICAL OR PHYSICAL PROPERTIES
    • G01N33/00Investigating or analysing materials by specific methods not covered by groups G01N1/00 - G01N31/00
    • G01N33/48Biological material, e.g. blood, urine; Haemocytometers
    • G01N33/50Chemical analysis of biological material, e.g. blood, urine; Testing involving biospecific ligand binding methods; Immunological testing
    • G01N33/58Chemical analysis of biological material, e.g. blood, urine; Testing involving biospecific ligand binding methods; Immunological testing involving labelled substances
    • G01N33/582Chemical analysis of biological material, e.g. blood, urine; Testing involving biospecific ligand binding methods; Immunological testing involving labelled substances with fluorescent label

Definitions

  • the present invention relates to methods for the detection of human platelet alloantigens (HPAs) on human platelets, methods for the detection of human antibodies against HPAs, and diagnostic test devices for carrying out said methods.
  • HPAs human platelet alloantigens
  • Blood transfusions are a routine therapy all over the world. Typically, not whole blood is transfused but only specific components of blood. Blood consists of a liquid part and a cellular part. The liquid part is called plasma and contains numerous proteins. Blood plasma is used as a therapeutic either as whole fresh or frozen plasma or as blood plasma components which are purified by biochemical means from the plasma and given as a specific therapeutic. Respective examples are immunoglobulins such as intravenous immunoglobulins (IVIG) or blood coagulation factors.
  • IVIG intravenous immunoglobulins
  • the cellular fraction of blood contains three types of cells, red cells, white cells and platelets. Red cell transfusion constitutes the majority of therapeutic cellular products of blood banks followed by platelet concentrates, numbering approximately one tenth of red cell concentrates.
  • Blood products are from individual donors and are subject to intensive diagnostic testing.
  • the first group of tests is to determine the surface antigens on cells, as these antigens can vary from donor to donor. These are the well known blood groups with the major antigens ABO and more than 30 other minor antigens known and described. Moreover, sera and/or plasma are tested for antibodies against these antigens.
  • the second group of tests done routinely are tests for the absence or presence of infectious diseases in donor blood. This is to ensure that the therapeutic blood transfusion does not carry pathogenic agents. These tests are commonly done by a combination of antibody tests, such as blood plasma screening for antibodies against HIV, HBV, HCV, the ToRCH panel tests, and plasma antigen tests for pathogen specific proteins, for example an HIV p24 antigen test.
  • antigen and antibody tests can be supplemented by a nucleic acid test for viral nucleic acids based on amplification methods, for example DNA/RNA amplification using the polymerase chain reaction (PCR).
  • PCR polymerase chain reaction
  • Platelet alloantigens result from biallelic polymorphisms of membrane glycoproteins of platelets. These polymorphisms give rise to single amino acid changes in the glycoproteins having no major biological consequences. However, upon transfusion of incompatible platelets, an alloimmunization can occur and lead to clinical symptoms, described below. Another source of alloimmunization occurs during pregnancy when the pregnant woman is immunized against alloantigens from the incompatible platelets of the fetus. Allo-antibodies against platelets are one source leading to clinical symptoms, but there are also auto-antibodies directed against platelets leading to thrombocytopenia.
  • HPAs The platelet alloantigens are well studied proteins and most of the relevant alloantigens are described.
  • a common nomenclature for HPAs exists describing HPA-1 to HPA-15. The convention is to designate the more common allele with "a” and the less common allele with "b”.
  • HPA-1a and HPA-5b antigens are the most immunogenic alloantigens, accounting together for over 95% of clinical cases in Caucasians. In Asian populations, HPA-4 alloimmunization is a relevant problem.
  • Other anti-platelet glycoprotein antibodies exist but are much less frequent.
  • HPA-1a and HPA-5b negative platelet concentrates as they offer the opportunity for a better treatment of patients with one of the three symptoms caused by anti-platelet antibodies, i.e. Neonatal Allo-Immune Thrombocytopenia (NAIT), Platelet Refractoriness (PR), or Post Transfusion Purpura (PTP).
  • NAIT Neonatal Allo-Immune Thrombocytopenia
  • PR Platelet Refractoriness
  • PTP Post Transfusion Purpura
  • Platelet antigen typing today is done only for patients and selected platelet donors.
  • the laboratories typically use homemade genotyping assays and phenotyping assays.
  • the most prominent platelet alloantigens are HPA-1a and HPA-5b.
  • HPA-1a typing tests are done by phenotyping but this approach has not found widespread use.
  • One reason for the absence of phenotyping assays is the lack of suitable monoclonal typing reagents for determining platelet phenotypes and a lengthy and tedious procedure for phenotyping.
  • monoclonal antibody for HPA-1a typing exists, however it has not been adapted widely in routine practice.
  • Blood bank screening of platelets has two major advantages as firstly it generates benefit by improved safety for the recipient patient and secondly it avoids inappropriate and useless donations of cost intensive platelet preparations to the wrong patient.
  • Platelet antibody diagnostics is performed on patient blood samples with diseases caused by platelet antibodies, such as NAIT, PR, and PTP.
  • platelet antibodies such as NAIT, PR, and PTP.
  • MAIPA Monoclonal Antibody Immobilization of Platelet Antigen
  • PIFT Platelet Immune Fluorescence Test
  • IVD in vitro diagnostic
  • the technical problem underlying the present invention is to provide methods for the detection of human platelet alloantigens (HPAs) on human platelets, methods for the detection of human antibodies against platelet antigens, and diagnostic test devices for carrying out said methods.
  • Said methods should be easy to perform, cost-efficient, and deliver results in a short time.
  • the present invention relates to a first method for the detection of at least one human platelet alloantigen (HPA) on human platelets contained in a sample, comprising the steps:
  • the term “detection” is not specifically restricted and does not only include the qualitative measurement of HPAs of interest but expressly includes the quantitative determination thereof.
  • “qualitative” as used herein means a determination of the presence or absence of an HPA of interest within a specific sample, while the term “quantitative” as used herein means a measurement of the content or amount of an HPA to be detected within a specific sample.
  • HPAs to be detected with the above first method of the present invention are not particularly limited and are known in the art.
  • the at least one HPA is selected from the group consisting of HPA-1a, HPA-1b, HPA-2a, HPA-2b, HPA-3a, HPA-3b, HPA-4a, HPA-4b, HPA-5a, HPA-5b, HPA-6a, HPA-6b, HPA-7a, HPA-7b, HPA-8a, HPA-8b, HPA-9a, HPA-9b, HPA-10a, HPA-10b, HPA-11a, HPA-11b, HPA-12a, HPA-12b, HPA-13a, HPA-13b, HPA-14a, HPA-14b, HPA-15a, and HPA-15b.
  • the at least one HPA is selected from the group consisting of HPA-1a, HPA-1b, HPA-3a, HPA-3b, HPA-4a, HPA-4b, HPA-5a, and HPA-5b. Even more preferably, the at least one HPA is selected from the group consisting of HPA-1a and HPA-5b, i.e. HPA-1a and/or HPA-5b are detected.
  • At least one HPA is detected.
  • more than one HPA can be detected, e.g. 2, 3, 4, 5, or more HPAs.
  • an according number of surfaces is provided in step (a), e.g. when two HPAs are to be detected, two surfaces are provided. Further, all surfaces provided in step (a) are contacted in steps (c) and (d), and the respective fluorescently labeled antibodies directed against the HPAs to be detected are used in step (d). Furthermore, all surface-bound complexes are excited in step (e), measured in step (f), and all respective HPAs are detected in step (g).
  • the sample to be analyzed in the above first method of the present invention is not particularly limited, provided it is a sample that contains or is suspected of containing platelets.
  • said sample is anti-coagulated whole blood or a blood product derived therefrom containing platelets such as e.g. a buffy coat or a platelet concentrate.
  • anti-coagulated whole blood may be preferably used in the final test, e.g. in concentrations of more than 10%, e.g. more than 25%, more than 33%, more than 50% or even more than 80%.
  • the above first method of the present invention allows to detect and distinguish with high sensitivity glycoproteins differing from each other by only one single amino acid polymorphism.
  • contacting the surface or “contacting said surface” as used in this aspect are intended to relate to the contacting of surfaces that are saturated with e.g. antibodies, blocking agents, antibody-antigen complexes, or other complexes that can occur in the methods of the present invention.
  • a person skilled in the art will understand that e.g. in step (c) of the above first method, the sample actually does not contact the surface, but the antibodies of step (a) or optionally blocking agents that are bound thereto, since said surface is saturated with said antibodies and optionally with blocking agents, and, therefore, is actually not accessible.
  • the above terms are chosen to reflect the macroscopic viewpoint of a practitioner working the present invention, who will merely see a surface, and will know what is actually bound to said surface at any given point.
  • the surfaces provided in the above first method of the present invention are made of materials that are not particularly limited and are known in the art.
  • such materials are glass or a plastic, preferably a plastic, such as polystyrene, polypropylene, polyethylene, polyethylene terephthalate, polycycloolefin, polyacrylnitrile, polymethylmethacrylate and/or mixtures and blends of these plastics.
  • a plastic such as polystyrene, polypropylene, polyethylene, polyethylene terephthalate, polycycloolefin, polyacrylnitrile, polymethylmethacrylate and/or mixtures and blends of these plastics.
  • any plastic that basically absorbs no light in the visible range is suitable.
  • the plastic can also be dyed light blue, for example, in order to filter out an emission caused by scatter light.
  • the above surface is the inside of a concave container, like a cuvette or a well of a microtiter plate or of a test cartridge, for example.
  • a concave container like a cuvette or a well of a microtiter plate or of a test cartridge, for example.
  • Such cuvettes, microtiter plates and test cartridges can be obtained inexpensively by injection molding and preferably have a reaction volume for the liquid of 1 to 400 ⁇ l, especially preferred 5 to 100 ⁇ l, and most preferred 10 to 40 ⁇ l.
  • the cuvettes, microtiter plates or test cartridges are made in one piece.
  • the expression "test cartridge” is not specifically restricted and includes any object which may be used to provide a surface on which the antibody of step (a) of the above first method of the present invention is bound and which may be contacted with the respective solutions or reactants.
  • the test cartridge may be a one-way disposable measurement cartridge that contains multiple, fully separated measurement wells, which are pre-conditioned to the specific measurement needs
  • the term "bound" preferably means that the antibody of step (a) is adhered to the surface by absorption (direct absorption).
  • said antibody may also be bound to the surface via a bridge element, for example a protein, such as a further antibody or an antigen.
  • Said antibody may also be bound to the surface by a covalent bond. This can be e.g. produced using an acrylate surface by conversion with a carbodiimide.
  • the term "bound” in the sense of the present invention includes adhesion to a surface or to another ligand, and includes both covalent and non-covalent interactions, like for example interactions based on ionic, polar or non-polar interactions.
  • the antibody of step (a) can be placed on the surface by a common method.
  • said antibody can be coated on the surface.
  • the surface is preferably treated with another solution, and sites on the surface not adhered to said antibody are blocked or will be blocked, for example by another protein or a chemical compound such as a detergent.
  • the antibody of step (a) can form a complex, wherein this complex at least includes, besides said antibody, the fluorescently labeled antibody of step (d) and the glycoprotein carrying the HPA to be detected.
  • this complex With the antibody of step (a) bound to the surface, the complex with the glycoprotein carrying the HPA to be detected is "anchored" to the surface, i.e. fixed thereto and can at the same time be detected by marking it with the antibody of step (d) containing the fluorophor.
  • the antibody of step (a) of the above first method of the present invention is not particularly limited, provided it is directed against the glycoprotein carrying the at least one HPA to be detected, i.e. provided it specifically binds to said glycoprotein.
  • Suitable antibodies are known in the art and can be obtained e.g. commercially. Such antibodies are not specifically restricted concerning their isotype or their origin. Exemplary antibodies in this context could be for example murine IgG antibodies.
  • Glycoproteins of interest in this respect are known in the art and include in particular gpIIbIIIa, gpIaIIa, gpIbIX and HLA/beta-2-microglobulin.
  • antibodies that can be used in this respect are the monoclonal anti-gpIIbIIIa antibody RFGP56 and the monoclonal anti-gpIaIIa antibody AK7.
  • Other suitable antibodies are for example the anti-gpIIbIIIa clone P2 Immuntech or the anti-gpIaIIa clones Gi9 and Y418. Many more suitable antibodies can be found by the person skilled in the art.
  • the fluorescently labeled antibody of step (d) of the above first method of the present invention is not particularly limited, provided it is directed against the HPA to be detected, i.e. provided it specifically binds to said HPA.
  • Suitable antibodies are not specifically restricted concerning their isotype and origin, and are known in the art.
  • the fluorescent label of said antibody is not particularly restricted, provided it can emit fluorescent light when excited with an evanescence field of a light source. Suitable fluorescent labels are known in the art.
  • said fluorescent label is allo-phycocyanine (APC).
  • the antibody of step (a) and the antibody of step (d) have different specificities, i.e. they bind to different epitopes.
  • the antibody of step (a) and the antibody of step (d) can be exchanged, i.e. the antibody of step (a) is directed against the at least one HPA to be detected, and the fluorescently labeled antibody of step (d) is directed against the glycoprotein carrying the at least one HPA to be detected.
  • said antibodies, as well as the fluorescent label are as defined above.
  • the term "antibody” does not only refer to the respective antibody as such, but also includes any fragments and derivatives of said antibody, provided that said fragments retain the ability to specifically bind to the same epitope. Respective fragments can be Fab fragments, F(ab') fragments, or F(ab') 2 fragments. Further, instead of antibodies or antibody fragments, any other macromolecules having the ability to specifically bind to an epitope can be used. Such macromolecules include for example nucleotide aptamers, peptide aptamers, nanobodies, affibodies, anticalins, DARPins, phylomers, AdNectins, and Protein A.
  • step (b) platelets contained in the sample are lysed and the membrane proteins of said platelets solubilized.
  • Methods and agents for lysing and solubilization are not particularly limited and are known in the art. They include for example the treatment of said platelets with suitable concentrations of surfactants such as Tween 20 (polysorbate 20; polyoxyethylene (20) sorbitan monolaurate) or NP40 (nonyl phenoxypolyethoxylethanol).
  • the steps (c) and (d) can be performed subsequently or concurrently.
  • the fluorescently labeled antibody of step (d) can be contained in the lysing and solubilization solution formed in step (b), so that steps (c) and (d) are performed concurrently when the respective solution is contacted with the surface.
  • the above first method of the present invention does not require more than two, more preferably more than one, liquid manipulation steps.
  • the expression "liquid manipulation step” as used herein generally includes any step which transfers, removes or adds a liquid from and/or to a site of action.
  • liquid manipulation steps according to the present invention include adding, e.g. by pipetting, a liquid into the well of a cuvette, a microtiter plate or a test cartridge, or removing a liquid from such a well.
  • the above first method of the present invention does not include any washing steps.
  • the first method of the present invention does preferably not require any steps of removing the volume containing excess reactants, such as the fluorescently labeled antibody of step (d), and/or washing the surface on which the antibody of step (a) and/or the complex to be measured are bound. This advantageously accelerates the above first method of the present invention to rapidly obtain the desired measurement results, avoids accumulation of waste liquids and operational errors when carrying out the method.
  • the first method as defined above is a one-step method.
  • “one-step” method means that only one complex-forming reaction takes place, which generally requires only one or at most two liquid manipulation steps to be conducted by the operator in order to obtain the desired measurement result.
  • further reaction steps such as the addition of more reagents after initial complex-formation are advantageously avoided.
  • liquid agitation is not specifically limited and includes any type of agitation which occurs in the liquid, except for natural diffusion.
  • liquid agitation in the sense of the present invention includes shaking, pumping, stirring, ultrasonic agitation, etc.
  • the result determined in step (g) is obtained within 30 minutes, preferably 20 minutes, more preferably 10 minutes or less starting from the beginning of step (c).
  • the qualitative or quantitative result is obtained within 30 minutes, preferably 20 minutes, more preferably 10 minutes or less after the solution containing the lysed and solubilized sample and the fluorescently labeled antibody of step (d) has been contacted with the surface to which the antibody of step (a) is bound.
  • the result is obtained within 9 minutes or less, 8 minutes or less or 7 minutes or less. Further examples include periods of 6 minutes or less, 5 minutes or less or 4 minutes or less.
  • said surface is contacted prior to step (e) with at least one dye that absorbs in the absorption and/or emission range of the fluorescent label of the antibody of step (d).
  • excitation of the fluorophor in the volume i.e. of fluorophor not part of the surface-bound complex, can be suppressed if the solution to be placed in contact with the surface has at least one dye added to it that has an absorption in the absorption and/or emissions range of said fluorophor.
  • the absorption of the dye added to the volume is coordinated with the absorption and/or emission range of said fluorophor.
  • One individual dye or a mixture of dyes can be used.
  • the absorption range of the fluorophor generally correlates with the wavelength of the light source used. It is not necessary that the dye has an absorption maximum in this special range; a shoulder in the absorption spectrum can suffice.
  • the dye used can have absorption between 600 nm and 700 nm, like for example Brilliant Blue FCF.
  • Another example of a dye that can be used in this respect is Brilliant Black BN.
  • the concentration of dye added depends on both the absorption coefficient of each dye in solution and the frequency of the light radiated. The concentration of dye can be adjusted, depending on the dye, so that the penetrating light can basically be absorbed to an extent of over 90% absorbance within 0.1 mm above the surface.
  • the surface-bound complex generated in step (a) to (d) of said method is excited with an evanescence field of a light source, the fluorescence emitted from said complex is measured, and the at least one HPA of interest is detected based on the measured emitted fluorescence, wherein a positive fluorescence signal indicates the presence of said complex and, thus, the presence of the at least one HPA of interest.
  • the term "light source” as used herein is not specifically restricted and includes any light source which is suited to create an evanescence field and excite the fluorophor bound to the antibody of step (d).
  • monochromatic light may be used as the light source.
  • Light should be used that has a wavelength that preferably does not interfere with the emission of the fluorophor and preferably intersects with the absorption band of the dye.
  • a laser is especially preferred as a light source, whose light emits a wavelength of 635 nm.
  • the above first method of the present invention is based on a new technology for analysis of biomolecules using the evanescence field excitation of bound fluorophors and measuring directly the binding events in real.time as described in the European patents EP 1 079 226 B1 , EP 1 204 856 B1 , and EP 1 371 967 B1 .
  • the functional principle of this evanescence field biosensor is the interaction of a surface-bound analyte with a ligand in solution by a non-covalent interaction.
  • the ligand in solution is attached covalently to a fluorescent molecule.
  • Preferred excitation of the fluorescent molecule is with coherent light such as generated by e.g. a laser diode and then the emitted photons are detected.
  • Suitable fluorophors for this are for example Cy5, Alexa dyes or the light-harvesting protein Allo-phycocyanine (APC).
  • the biochemical reaction takes place in a small well, similar to an ELISA well in form and dimensions with an additional optical entity on the bottom.
  • the biosensor well and its optical bottom part are produced by injection molding of thermoplastic material, like e.g. polystyrene.
  • Major differences between the ELISA method and the evanescence biosensor methods are the labels of the ligand in solution.
  • the label is an enzyme and for the evanescence technology the ligand is labeled with a fluorescent molecule. Measurement of the bound fluorophor, i.e.
  • the fluorescing ligand in solution binding to the analyte immobilized on the evanescent surface is achieved by specific excitation of the bound fluorescently labeled ligand using the evanescence field excitation principle.
  • Selective excitation of the bound fluorophor occurs by an evanescence field of light using an optical construction resulting in a specific excitation of an approximately 200 nm thick layer of liquid located at the bottom of the well and not exciting the fluorescently labeled ligand in excess present in the solution above the binding surface. Only fluorescently labeled ligands residing in the evanescent field are excited and emit photons. This method allows the observation of a binding reaction of the soluble ligand with the immobilized ligand in real time.
  • the evanescence biosensor allows to perform in vitro diagnostic assays in short time.
  • the complex and costly instrumentation of ELISA automates or for bead based immune assays are neither required nor necessary when using the evanescence biosensor for diagnostic applications.
  • the present invention relates to a first diagnostic test device for carrying out the above first method according to the present invention, comprising at least one surface having at least the antibody of step (a) bound thereto.
  • the surface, the antibody of step (a), suitable lysing and solubilizing agents used in step (b), and the fluorescently labeled antibody of step (d) are as defined above. Further, the definitions given above apply also to this aspect of the present invention.
  • the above first diagnostic test device of the present invention has the form of a cuvette, microtiter plate or test cartridge, preferably being made of glass or a plastic, preferably a plastic, such as polystyrene, polypropylene, polyethylene, polyethylene terephthalate, polycycloolefin, polyacryinitrile, polymethylmethacrylate and/or mixtures and blends of these plastics.
  • a plastic such as polystyrene, polypropylene, polyethylene, polyethylene terephthalate, polycycloolefin, polyacryinitrile, polymethylmethacrylate and/or mixtures and blends of these plastics.
  • any plastic that basically absorbs no light in the visible range is suitable.
  • the plastic can also be dyed light blue, for example, in order to filter out an emission caused by scatter light.
  • Plastic cuvettes, microtiter plates and test cartridges can be obtained inexpensively by injection molding and preferably have a reaction volume of 1 to 400 ⁇ l, especially preferred 5 to 100 ⁇ l, and most preferred 10 to 40 ⁇ l.
  • the cuvettes, microtiter plates or test cartridges of the present invention are made in one piece.
  • test cartridge is not specifically restricted and includes any object which may be used to provide a surface on which the antibody of step (a) is bound and which may be contacted with the respective solutions or reactants.
  • the test cartridge may be a one-way disposable measurement cartridge that contains multiple, fully separated measurement wells, which are pre-conditioned to the specific measurement needs.
  • test cartridge has multiple wells
  • multiple assays can be run in parallel.
  • Respective examples include the typing of several allo-antigens at the same time, optionally including positive and negative internal controls for controlling the performance of the tests.
  • Another example could be the typing of one or more allo-antigens and the establishment of a calibration curve at the same time.
  • the present invention relates to a second method for the detection of human antibodies directed against human platelet alloantigens (HPAs), in a sample, comprising the steps:
  • the term “detection” is not specifically restricted and does not only include the qualitative measurement of human antibodies directed against HPAs of interest but expressly includes the quantitative determination thereof.
  • “qualitative” as used herein means a determination of the presence or absence of an antibody of interest within a specific sample, while the term “quantitative” as used herein means a measurement of the content or amount of an antibody to be detected within a specific sample.
  • Antibodies to be detected with the above second method of the present invention are not particularly limited and include any antibodies directed against an HPA.
  • said HPA is selected from the group consisting of HPA-1a, HPA-1b, HPA-2a, HPA-2b, HPA-3a, HPA-3b, HPA-4a, HPA-4b, HPA-5a, HPA-5b, HPA-6a, HPA-6b, HPA-7a, HPA-7b, HPA-8a, HPA-8b, HPA-9a, HPA-9b, HPA-10a, HPA-10b, HPA-11a, HPA-11b, HPA-12a, HPA-12b, HPA-13a, HPA-13b, HPA-14a, HPA-14b, HPA-15a, and HPA-15b.
  • said HPA is selected from the group consisting of HPA-1a, HPA-1b, HPA-3a, HPA-3b, HPA-4a, HPA-4b, HPA-5a, and HPA-5b. Even more preferably, said HPA is selected from the group consisting of HPA-1a and HPA-5b, i.e. antibodies directed against HPA-1a and/or HPA-5b are detected.
  • step (a) antibodies directed against one HPA or more HPAs are detected, e.g. 2, 3, 4, 5, or more antibodies directed against different HPAs.
  • an according number of surfaces is provided in step (a), e.g. when antibodies against two HPAs are to be detected, two surfaces are provided. Further, all surfaces provided in step (a) are contacted in steps (b) and (c). Furthermore, all surface-bound complexes are excited in step (d), measured in step (e), and all respective antibodies are detected in step (f).
  • the above second method of the present invention can be performed as a multiplex method, i.e. more than one, e.g. 2, 3, 4, 5, 6, 7, 8, or more different platelets or platelet membrane fractions can be coated in different positions on a surface, so that e.g. all HPAs or platelet allo-antigens can be covered.
  • a single microchip may be used in the above-defined second method which uses a selection of platelets or fragments thereof to cover all HPAs of interest, thus enabling the easy and quick determination of anti-HPA antibodies in a sample.
  • the sample to be analyzed in the above second method of the present invention is not particularly limited, provided it is a sample that contains or is suspected of containing antibodies against HPAs.
  • said sample is selected from the group consisting of blood plasma and blood serum.
  • contacting the surface or “contacting said surface” as used in this aspect are intended to relate to the contacting of surfaces that are saturated with e.g. platelets or platelet membrane fractions, blocking agents, platelet-antibody complexes, or other complexes that can occur in the methods of the present invention.
  • the sample actually does not contact the surface, but the human platelets or platelet membrane fractions of step (a) or optionally blocking agents that are bound thereto, since said surface is saturated with said human platelets or platelet membrane fractions and optionally with blocking agents, and, therefore, is actually not accessible.
  • the above terms are chosen to reflect the macroscopic viewpoint of a practitioner working the present invention, who will merely see a surface, and will know what is actually bound to said surface at any given point.
  • the surfaces provided in the above second method of the present invention are made of materials that are not particularly limited and are known in the art.
  • such materials are glass or a plastic, preferably a plastic, such as polystyrene, polypropylene, polyethylene, polyethylene terephthalate, polycycloolefin, polyacrylnitrile, polymethylmethacrylate and/or mixtures and blends of these plastics.
  • a plastic such as polystyrene, polypropylene, polyethylene, polyethylene terephthalate, polycycloolefin, polyacrylnitrile, polymethylmethacrylate and/or mixtures and blends of these plastics.
  • any plastic that basically absorbs no light in the visible range is suitable.
  • the plastic can also be dyed light blue, for example, in order to filter out an emission caused by scatter light.
  • the above surface is the inside of a concave container, like a cuvette or a well of a microtiter plate or of a test cartridge, for example.
  • a concave container like a cuvette or a well of a microtiter plate or of a test cartridge, for example.
  • Such cuvettes, microtiter plates and test cartridges can be obtained inexpensively by injection molding and preferably have a reaction volume of 1 to 400 ⁇ l, especially preferred 5 to 100 ⁇ l, and most preferred 10 to 40 ⁇ l.
  • the cuvettes, microtiter plates or test cartridges are made in one piece.
  • test cartridge is not specifically restricted and includes any object which may be used to provide a surface on which the human platelets or platelet membrane fractions of step (a) of the above second method of the present invention are bound and which may be contacted with the respective solutions or reactants.
  • the test cartridge may be a one-way disposable measurement cartridge that contains multiple, fully separated measurement wells, which are pre-conditioned to the specific measurement needs.
  • the term "bound" preferably means that the human platelets or platelet membrane fractions of step (a) are adhered to the surface by absorption (direct absorption).
  • said human platelets or platelet membrane fractions may also be bound to the surface via a bridge element, for example a protein, such as an antibody, e.g. an antibody directed against a common platelet surface antigen such as gpVI or beta-2-microglobulin.
  • a bridge element for example a protein, such as an antibody, e.g. an antibody directed against a common platelet surface antigen such as gpVI or beta-2-microglobulin.
  • Another possibility would be to biotinylate the platelets or platelet membrane fractions and bind them to an avidin- or streptavidin-coated surface.
  • Said human platelets or platelet membrane fractions may also be bound to the surface by a covalent bond. This can be e.g.
  • bound in the sense of the present invention includes adhesion to a surface or to another ligand, and includes both covalent and non-covalent interactions, like for example interactions based on ionic, polar or non-polar interactions.
  • the human platelets or platelet membrane fractions of step (a) can be placed on the surface by a common method.
  • said human platelets or platelet membrane fractions can be coated on the surface.
  • the surface is preferably treated with another solution, and sites on the surface not adhered to said human platelets or platelet membrane fractions are blocked or will be blocked, for example by a protein.
  • the platelets or platelet membrane fractions of step (a) can form a complex, wherein this complex at least includes, besides said platelets or platelet membrane fractions, the fluorescently labeled detection agent of step (c) and the human antibody directed against an HPA to be detected.
  • this complex With the platelets or platelet membrane fractions of step (a) bound to the surface, said complex is "anchored" to the surface, i.e. fixed thereto and can at the same time be detected by marking it with the fluorescently labeled detection agent of step (c) containing the fluorophor.
  • the human platelets or platelet membrane fractions of step (a) of the above second method of the present invention are not particularly limited, provided human platelets or platelet membrane fractions are used wherein the HPAs of interest that are present on said platelets or platelet membrane fractions are known.
  • human platelets or platelet membrane fractions that are HPA-1a positive have to be used in step (a).
  • Methods for obtaining human platelets or platelet membrane fractions carrying known HPAs are not particularly limited and are known in the art.
  • One way of generating platelet membrane fractions is for example to lyse platelets, e.g.
  • membranes chemically and/or mechanically, and to purify membrane fractions based on their solubility in aqueous buffers.
  • An alternative is to purify membranes based on their density, e.g. by sedimentation in a gravitational field by ultracentrifugation.
  • Another method to prepare membranes is sucrose density centrifugation. In this method, solid sucrose is added to a hypotonic cell lysate to a concentration of preferably 70%. The mixture is then centrifuged, preferably in an ultracentrifuge and the membranes float on the sucrose solution.
  • the minimal sucrose concentration to float membranes is 35%, so one can prepare step gradients by overlaying the 70% sucrose lysate with a 55% sucrose cushion and a 35% cushion on top of the 55% cushion.
  • An alternative is to generate small membranous liposomes by sonication and/or French press optionally followed by a sizing step.
  • the term "platelet membrane fractions" as used herein encompasses in some embodiments platelet-derived liposomes. Means for generating or obtaining platelet-derived liposomes are not particularly limited and are known in the art.
  • the fluorescently labeled detection agent of step (c) of the above second method of the present invention is not particularly limited, provided it can specifically bind to human antibodies directed against HPAs that are present on said platelets or platelet membrane fractions.
  • said detection agent is a fluorescently labeled antibody directed against human antibodies.
  • said antibody is not particularly limited, and suitable antibodies are known in the art and can be obtained e.g. commercially. Such antibodies are not specifically restricted concerning their isotype or their origin. Exemplary antibodies in this context could be for example murine IgG antibodies.
  • the fluorescent label of said antibody is not particularly restricted, provided it can emit fluorescent light when excited with an evanescence field of a light source. Suitable fluorescent labels are known in the art.
  • said fluorescent label is allo-phycocyanine (APC).
  • the above detection agent is fluorescently labeled platelets or platelet membrane fractions, wherein said platelets or platelet membrane fractions carry the same HPAs as the platelets or platelet membrane fractions of step (a).
  • said platelets or platelet membrane fractions are identical to the platelets or platelet membrane fractions of step (a), with the exception that the former is fluorescently labeled.
  • the fluorescent label of said platelets or platelet membrane fractions is not particularly restricted, provided it can emit fluorescent light when excited with an evanescence field of a light source. Suitable fluorescent labels are known in the art.
  • said fluorescent label is a lipophilic fluorescent dye that associates with the platelet membranes, e.g. a carbocyanine derivative.
  • Suitable lipophilic dyes and methods of labeling platelets are not particularly limited and are known in the art.
  • Exemplary dyes are the ebiosience CellVue dye series or the dyes available from Molecular Probes.
  • platelets could be labeled via a fluorescently labeled antibody directed against a platelet surface antigen, or via biotinylation of the platelets or platelet membrane fractions and interaction with fluorescently labeled avidin or streptavidin.
  • the above second method of the present invention uses primarily platelets or platelet fragments or platelet-derived liposomes all of which have in common the presence of native glycoproteins which are not denatured by a physical process or the activity of detergents for solubilizing. This is particularly important for the platelet glycoproteins which by nature often exist in a conformationally restricted form, and upon activation, such as by a physical treatment, a binding event or also by detergent treatment, change their conformation and are subsequently different form native glycoproteins resting on unactivated platelets in terms of their function and their characteristics as an antigen.
  • the term "antibody” does not only refer to the respective antibody as such, but also includes any fragments and derivatives of said antibody, provided that said fragments retain the ability to specifically bind to the same epitope.
  • Respective fragments can be Fab fragments, F(ab') fragments, or F(ab') 2 fragments.
  • any other macromolecules having the ability to specifically bind to an epitope can be used.
  • Such macromolecules include for example nucleotide aptamers, peptide aptamers, nanobodies, affibodies, anticalins, DARPins, phylomers, AdNectins, and Protein A.
  • the human antibodies directed against HPAs that are detected in the above second method of the present invention are not particularly limited and are preferably selected from the group consisting of IgG antibodies, IgA antibodies, IgE antibodies, and IgM antibodies.
  • the antibodies to be detected with said method are primarily allo-antibodies.
  • a therapy can be directed by choosing the right platelets of step (a).
  • said antibodies can also by auto-antibodies, wherein the allo-antigenic profile presented in step (a) is not relevant.
  • Respective auto-antibodies are the cause of PTP where a preformed anti-HPA-1a antibody, typically derived from a pregnancy, undergoes evolution and becomes an auto-antibody.
  • the steps (b) and (c) can be performed subsequently or concurrently.
  • the fluorescently labeled detection agent of step (c) can be combined with the, optionally diluted, sample before the surface is contacted, so that steps (b) and (c) are performed concurrently when the respective solution is contacted with the surface. Accordingly, the surface has only to be contacted with the, optionally diluted, sample, so that steps (b) and (c) are performed concurrently.
  • the above second method of the present invention does not require more than two, more preferably more than one, liquid manipulation steps.
  • the expression "liquid manipulation step” as used herein generally includes any step which transfers, removes or adds a liquid from and/or to a site of action.
  • liquid manipulation steps according to the present invention include adding, e.g. by pipetting, a liquid into the well of a cuvette, a microtiter plate or a test cartridge, or removing a liquid from such a well.
  • the above second method of the present invention does not include any washing steps.
  • the second method of the present invention does preferably not require any steps of removing the volume containing excess reactants, such as the fluorescently labeled detection agent of step (c), and/or washing the surface on which the platelets or platelet membrane fractions of step (a) and/or the complex to be measured are bound.
  • This advantageously accelerates the above second method of the present invention to rapidly obtain the desired measurement results, avoids accumulation of waste liquids and operational errors when carrying out the method.
  • the second method as defined above is a one-step method.
  • “one-step” method means that only one complex-forming reaction takes place, which generally requires only one or at most two liquid manipulation steps to be conducted by the operator in order to obtain the desired measurement result.
  • further reaction steps such as the addition of more reagents after initial complex-formation are advantageously avoided.
  • liquid agitation is not specifically limited and includes any type of agitation which occurs in the liquid, except for natural diffusion.
  • liquid agitation in the sense of the present invention includes shaking, pumping, stirring, ultrasonic agitation, etc.
  • the result determined in step (f) is obtained within 30 minutes, preferably 20 minutes, more preferably 10 minutes or less starting from the beginning of step (b).
  • the qualitative or quantitative result is obtained within 30 minutes, preferably 20 minutes, more preferably 10 minutes or less after the solution containing the sample and the fluorescently labeled detection agent of step (c) has been contacted with the surface to which the platelets or platelet membrane fractions of step (a) are bound.
  • the result is obtained within 9 minutes or less, 8 minutes or less or 7 minutes or less. Further examples include periods of 6 minutes or less, 5 minutes or less or 4 minutes or less.
  • said surface is contacted prior to step (d) with at least one dye that absorbs in the absorption and/or emission range of the fluorescent label of the detection agent of step (c).
  • excitation of the fluorophor in the volume i.e. of fluorophor not part of the surface-bound complex, can be suppressed if the solution to be placed in contact with the surface has at least one dye added to it that has an absorption in the absorption and/or emissions range of said fluorophor.
  • the absorption of the dye added to the volume is coordinated with the absorption and/or emission range of said fluorophor.
  • One individual dye or a mixture of dyes can be used.
  • the absorption range of the fluorophor generally correlates with the wavelength of the light source used. It is not necessary that the dye has an absorption maximum in this special range; a shoulder in the absorption spectrum can suffice.
  • the dye used can have absorption between 600 nm and 700 nm, like for example Brilliant Blue FCF.
  • Another example of a dye that can be used in this respect is Brilliant Black BN.
  • the concentration of dye added depends on both the absorption coefficient of each dye in solution and the frequency of the light radiated. The concentration of dye can be adjusted, depending on the dye, so that the penetrating light can basically be absorbed to an extent of over 90% absorbance within 0.1 mm above the surface.
  • the surface-bound complex generated in step (a) to (c) of said method is excited with an evanescence field of a light source, the fluorescence emitted from said complex is measured, and the human antibodies against the HPAs of interest are detected based on the measured emitted fluorescence, wherein a positive fluorescence signal indicates the presence of said complex and, thus, the presence of human antibodies directed against the HPAs of interest.
  • the term "light source” as used herein is not specifically restricted and includes any light source which is suited to create an evanescence field and excite the fluorophor bound to the detection agent of step (c).
  • monochromatic light may be used as the light source.
  • Light should be used that has a wavelength that preferably does not interfere with the emission of the fluorophor and preferably intersects with the absorption band of the dye.
  • a laser is especially preferred as a light source, whose light emits a wavelength of 635 nm.
  • the above second method of the present invention is based on a new technology for analysis of biomolecules using the evanescence field excitation of bound fluorophors and measuring directly the binding events in real time as described in the European patents EP 1 079 226 B1 , EP 1 204 856 B1 , and EP 1 371 967 B1 .
  • the functional principle of this evanescence field biosensor is the interaction of a surface-bound analyte with a ligand in solution by a non-covalent interaction.
  • the ligand in solution is attached covalently to a fluorescent molecule.
  • Preferred excitation of the fluorescent molecule is with coherent light such as generated by e.g. a laser diode and then the emitted photons are detected.
  • Suitable fluorophors for this are for example Cy5, Alexa dyes or the light-harvesting protein Allo-phycocyanine (APC).
  • the biochemical reaction takes place in a small well, similar to an ELISA well in form and dimensions with an additional optical entity on the bottom.
  • the biosensor well and its optical bottom part are produced by injection molding of thermoplastic material, like e.g. polystyrene.
  • Major differences between the ELISA method and the evanescence biosensor methods are the labels of the ligand in solution.
  • the label is an enzyme and for the evanescence technology the ligand is labeled with a fluorescent molecule. Measurement of the bound fluorophor, i.e.
  • the fluorescing ligand in solution binding to the analyte immobilized on the evanescent surface is achieved by specific excitation of the bound fluorescently labeled ligand using the evanescence field excitation principle.
  • Selective excitation of the bound fluorophor occurs by an evanescence field of light using an optical construction resulting in a specific excitation of an approximately 200 nm thick layer of liquid located at the bottom of the well and not exciting the fluorescently labeled ligand in excess present in the solution above the binding surface. Only fluorescently labeled ligands residing in the evanescent field are excited and emit photons. This method allows the observation of a binding reaction of the soluble ligand with the immobilized ligand in real time.
  • the evanescence biosensor allows to perform in vitro diagnostic assays in short time.
  • the complex and costly instrumentation of ELISA automates or for bead based immune assays are neither required nor necessary when using the evanescence biosensor for diagnostic applications.
  • the present invention relates to a second diagnostic test device for carrying out the above second method according to the present invention, comprising at least one surface having at least the human platelets or platelet membrane fractions of step (a) bound thereto, wherein the HPAs that are present on said platelets or platelet membrane fractions are known.
  • the surface, the human platelets or platelet membrane fractions of step (a), and the fluorescently labeled detection agent of step (c) are as defined above. Further, the definitions given above apply also to this aspect of the present invention.
  • the evanescence field being 200 nm in height and the platelets used for coating the sensing surface having a diameter of 1 to 4 micrometers, one still can observe a signal.
  • the coated platelet and the platelet membrane is within the evanescent field and, therefore, can absorb and consequently emit fluorescent signals, whereas the majority of the 2-3 micrometer platelet and the platelet surface antigens are outside of the evanescent field. This indicates a rather high stability of the system towards the dimensions of the biological analyte.
  • coated platelets and platelet fragments are rich in enzymes and enzymatic activities such as peroxidases and phosphatase, which are enzymes commonly used as labels for ELISA tests.
  • enzymes and enzymatic activities such as peroxidases and phosphatase, which are enzymes commonly used as labels for ELISA tests.
  • fluorescence detection using evanescence excitation avoids any problems that could result from those contaminating enzymes altogether.
  • the above second diagnostic test device of the present invention has the form of a cuvette, microtiter plate or test cartridge, preferably being made of glass or a plastic, preferably a plastic, such as polystyrene, polypropylene, polyethylene, polyethylene terephthalate, polycycloolefin, polyacrylnitrile, polymethylmethacrylate and/or mixtures and blends of these plastics.
  • a plastic such as polystyrene, polypropylene, polyethylene, polyethylene terephthalate, polycycloolefin, polyacrylnitrile, polymethylmethacrylate and/or mixtures and blends of these plastics.
  • any plastic that basically absorbs no light in the visible range is suitable.
  • the plastic can also be dyed light blue, for example, in order to filter out an emission caused by scatter light.
  • Plastic cuvettes, microtiter plates and test cartridges can be obtained inexpensively by injection molding and preferably have a reaction volume of 1 to 400 ⁇ l, especially preferred 5 to 100 ⁇ l, and most preferred 10 to 40 ⁇ l.
  • the cuvettes, microtiter plates or test cartridges of the present invention are made in one piece.
  • test cartridge is not specifically restricted and includes any object which may be used to provide a surface on which the human platelets or platelet membrane fractions of step (a) are bound and which may be contacted with the respective solutions or reactants.
  • the test cartridge may be a one-way disposable measurement cartridge that contains multiple, fully separated measurement wells, which are pre-conditioned to the specific measurement needs.
  • test cartridge has multiple wells
  • multiple assays can be run in parallel.
  • the present invention relates to a third method for the detection of human antibodies directed against human platelet alloantigens (HPAs), in a sample, comprising the steps:
  • the term “detection” is not specifically restricted and does not only include the qualitative measurement of human antibodies directed against HPAs of interest but expressly includes the quantitative determination thereof.
  • “qualitative” as used herein means a determination of the presence or absence of an antibody of interest within a specific sample, while the term “quantitative” as used herein means a measurement of the content or amount of an antibody to be detected within a specific sample.
  • Antibodies to be detected with the above third method of the present invention are not particularly limited and include any antibodies directed against an HPA.
  • said HPA is selected from the group consisting of HPA-1a, HPA-1b, HPA-2a, HPA-2b, HPA-3a, HPA-3b, HPA-4a, HPA-4b, HPA-5a, HPA-5b, HPA-6a, HPA-6b, HPA-7a, HPA-7b, HPA-8a, HPA-8b, HPA-9a, HPA-9b, HPA-10a, HPA-10b, HPA-11a, HPA-11b, HPA-12a, HPA-12b, HPA-13a, HPA-13b, HPA-14a, HPA-14b, HPA-15a, and HPA-15b.
  • said HPA is selected from the group consisting of HPA-1a, HPA-1b, HPA-3a, HPA-3b, HPA-4a, HPA-4b, HPA-5a, and HPA-5b. Even more preferably, said HPA is selected from the group consisting of HPA-1a and HPA-5b, i.e. antibodies directed against HPA-1a and/or HPA-5b are detected.
  • antibodies directed against one HPA or more HPAs are detected, e.g. 2, 3, 4, 5, or more antibodies directed against different HPAs.
  • more than one MAIPA assay is conducted in step (a), and an according number of surfaces is provided in step (b), e.g. when antibodies against two HPAs are to be detected, two surfaces are provided.
  • all surfaces provided in step (b) are contacted in steps (c) and (d).
  • all surface-bound complexes are excited in step (e), measured in step (f), and all respective antibodies are detected in step (g).
  • a MAIPA assay is also useful for detecting auto-antibodies, which is also within the scope of the present invention.
  • Patient platelets are examined for bound human IgG by just sensitizing with mouse monoclonal antibodies, then washing and solubilizing the tri-molecular complex.
  • a MAIPA assay can be performed in step (a) which uses not only one antibody directed against one platelet glycoprotein, but 2, 3, 4 or more antibodies directed against a respective number of platelet glycoproteins.
  • antibodies directed against gpIIbIIIa, gpIaIIa, gpIbIX and HLA/beta-2-microglobulin can be used in one reaction, so that tri-molecular complexes between said antibodies, all respective glycoproteins, and all human antibodies contained in the sample that are directed against the HPAs that are present on said glycoproteins are formed in one reaction.
  • These tri-molecular complexes can then by further analyzed in the above third method of the present invention.
  • the MAIPA assay and ways to generate respective tri-molecular complexes using said assay are not particularly limited and are known in the art.
  • said MAIPA assay comprises the steps:
  • lysing platelets and solubilizing the at least one tri-molecular complex can be effected as described above in the first method of the present invention for the lysing of platelets and solubilizing of membrane proteins.
  • the antibody of step (a1) and the human antibody of step (a2) have different specificities, i.e. they bind to different epitopes.
  • the sample to be analyzed in the above third method of the present invention is not particularly limited, provided it is a sample that contains or is suspected of containing antibodies against HPAs.
  • said sample is selected from the group consisting of blood plasma and blood serum.
  • contacting the surface or "contacting said surface” as used in this aspect are intended to relate to the contacting of surfaces that are saturated with e.g. antibodies, blocking agents, or complexes that can occur in the methods of the present invention.
  • a person skilled in the art will understand that e.g. in step (c) of the above third method, the tri-molecular complex actually does not contact the surface, but the antibodies of step (b) or optionally blocking agents that are bound thereto, since said surface is saturated with said antibodies and optionally with blocking agents, and, therefore, is actually not accessible.
  • the above terms are chosen to reflect the macroscopic viewpoint of a practitioner working the present invention, who will merely see a surface, and will know what is actually bound to said surface at any given point.
  • the surfaces provided in the above third method of the present invention are made of materials that are not particularly limited and are known in the art.
  • such materials are glass or a plastic, preferably a plastic, such as polystyrene, polypropylene, polyethylene, polyethylene terephthalate, polycycloolefin, polyacrylnitrile, polymethylmethacrylate and/or mixtures and blends of these plastics.
  • a plastic such as polystyrene, polypropylene, polyethylene, polyethylene terephthalate, polycycloolefin, polyacrylnitrile, polymethylmethacrylate and/or mixtures and blends of these plastics.
  • any plastic that basically absorbs no light in the visible range is suitable.
  • the plastic can also be dyed light blue, for example, in order to filter out an emission caused by scatter light.
  • the above surface is the inside of a concave container, like a cuvette or a well of a microtiter plate or of a test cartridge, for example.
  • a concave container like a cuvette or a well of a microtiter plate or of a test cartridge, for example.
  • Such cuvettes, microtiter plates and test cartridges can be obtained inexpensively by injection molding and preferably have a reaction volume of 1 to 400 ⁇ l, especially preferred 5 to 200 ⁇ l, and most preferred 10 to 40 ⁇ l.
  • the cuvettes, microtiter plates or test cartridges are made in one piece.
  • the expression "test cartridge” is not specifically restricted and includes any object which may be used to provide a surface on which antibodies of step (b) of the above third method of the present invention are bound and which may be contacted with the respective solutions or reactants.
  • the test cartridge may be a one-way disposable measurement cartridge that contains multiple, fully separated measurement wells, which are pre-conditioned to the specific measurement needs.
  • the term "bound" preferably means that the antibody of step (b) is adhered to the surface by absorption (direct absorption).
  • said antibody may also be bound to the surface via a bridge element, for example a protein, such as a further antibody or an antigen.
  • Said antibody may also be bound to the surface by a covalent bond. This can be e.g. produced using an acrylate surface by conversion with a carbodiimide.
  • the term "bound” in the sense of the present invention includes adhesion to a surface or to another ligand, and includes both covalent and non-covalent interactions, like for example interactions based on ionic, polar or non-polar interactions.
  • the antibody of step (b) can be placed on the surface by a common method.
  • said antibody can be coated on the surface.
  • the surface is preferably treated with another solution, and sites on the surface not adhered to said antibody are blocked or will be blocked, for example by another protein.
  • the antibody of step (b) can form a complex, wherein this complex at least includes, besides said antibody, the tri-molecular complex generated in step (a), and the fluorescently labeled antibody of step (d).
  • this complex With the antibody of step (b) bound to the surface, the complex with said tri-molecular complex generated in step (a) is "anchored" to the surface, i.e. fixed thereto and can at the same time be detected by marking it with the antibody of step (d) containing the fluorophor.
  • the antibody of step (b) of the above third method of the present invention is not particularly limited, provided it is directed against the at least one antibody directed against said at least one platelet glycoprotein, i.e. provided it specifically binds to said antibody.
  • Suitable antibodies are known in the art and can be obtained e.g. commercially. Such antibodies are not specifically restricted concerning their isotype or their origin. Exemplary antibodies in this context could be for example murine IgG antibodies.
  • the fluorescently labeled antibody of step (d) of the above third method of the present invention is not particularly limited, provided it is directed against human antibodies, i.e. provided it specifically binds to said human antibodies. Suitable antibodies are not specifically restricted concerning their isotype and origin, and are known in the art. Further, the fluorescent label of said antibody is not particularly restricted, provided it can emit fluorescent light when excited with an evanescence field of a light source. Suitable fluorescent labels are known in the art. In a preferred embodiment, said fluorescent label is allo-phycocyanine (APC).
  • APC allo-phycocyanine
  • the antibody of step (b) and the antibody of step (d) can be exchanged, i.e. the antibody of step (b) is directed against human antibodies, and the fluorescently labeled antibody of step (d) is directed against the at least one antibody directed against the at least one glycoprotein.
  • said antibodies, as well as the fluorescent label are as defined above.
  • the term "antibody” does not only refer to the respective antibody as such, but also includes any fragments and derivatives of said antibody, provided that said fragments retain the ability to specifically bind to the same epitope.
  • Respective fragments can be Fab fragments, F(ab') fragments, or F(ab') 2 fragments.
  • any other macromolecules having the ability to specifically bind to an epitope can be used.
  • Such macromolecules include for example nucleotide aptamers, peptide aptamers, nanobodies, affibodies, anticalins, DARPins, phylomers, AdNectins, and Protein A.
  • the human antibodies directed against HPAs that are detected in the above third method of the present invention are not particularly limited and are preferably selected from the group consisting of IgG antibodies, IgA antibodies, IgE antibodies, and IgM antibodies.
  • the steps (c) and (d) can be performed subsequently or concurrently.
  • the fluorescently labeled antibody of step (d) can be combined with the solution containing the at least one tri-molecular complex formed in step (a) before the surface is contacted, so that steps (c) and (d) are performed concurrently when the respective solution is contacted with the surface. Accordingly, the surface has only to be contacted with the solution containing the at least one tri-molecular complex formed in step (a), so that steps (c) and (d) are performed concurrently.
  • the above third method of the present invention does not require more than two, more preferably more than one, liquid manipulation steps.
  • the expression "liquid manipulation step” as used herein generally includes any step which transfers, removes or adds a liquid from and/or to a site of action.
  • liquid manipulation steps according to the present invention include adding, e.g. by pipetting, a liquid into the well of a cuvette, a microtiter plate or a test cartridge, or removing a liquid from such a well.
  • the above third method of the present invention does not include any washing steps.
  • the third method of the present invention does preferably not require any steps of removing the volume containing excess reactants, such as the fluorescently labeled antibody of step (d), and/or washing the surface on which the antibodies of step (b) and/or the complex to be measured are bound. This advantageously accelerates the above third method of the present invention to rapidly obtain the desired measurement results, avoids accumulation of waste liquids and operational errors when carrying out the method.
  • the third method as defined above is a one-step method.
  • "one-step” method means that only one complex-forming reaction takes place, which generally requires only one or at most two liquid manipulation steps to be conducted by the operator in order to obtain the desired measurement result.
  • further reaction steps such as the addition of more reagents after initial complex-formation are advantageously avoided.
  • liquid agitation is not specifically limited and includes any type of agitation which occurs in the liquid, except for natural diffusion.
  • liquid agitation in the sense of the present invention includes shaking, pumping, stirring, ultrasonic agitation, etc.
  • the result determined in step (g) is obtained within 30 minutes, preferably 20 minutes, more preferably 10 minutes or less starting from the beginning of step (c).
  • the qualitative or quantitative result is obtained within 30 minutes, preferably 20 minutes, more preferably 10 minutes or less after the solution containing the sample and the fluorescently labeled antibody of step (d) has been contacted with the surface to which the antibodies of step (b) are bound.
  • the result is obtained within 9 minutes or less, 8 minutes or less or 7 minutes or less. Further examples include periods of 6 minutes or less, 5 minutes or less or 4 minutes or less.
  • said surface is contacted prior to step (e) with at least one dye that absorbs in the absorption and/or emission range of the fluorescent label of the antibody of step (d).
  • excitation of the fluorophor in the volume i.e. of fluorophor not part of the surface-bound complex, can be suppressed if the solution to be placed in contact with the surface has at least one dye added to it that has an absorption in the absorption and/or emissions range of said fluorophor.
  • the absorption of the dye added to the volume is coordinated with the absorption and/or emission range of said fluorophor.
  • One individual dye or a mixture of dyes can be used.
  • the absorption range of the fluorophor generally correlates with the wavelength of the light source used. It is not necessary that the dye has an absorption maximum in this special range; a shoulder in the absorption spectrum can suffice.
  • the dye used can have absorption between 600 nm and 700 nm, like for example Brilliant Blue FCF.
  • Another example of a dye that can be used in this respect is Brilliant Black BN.
  • the concentration of dye added depends on both the absorption coefficient of each dye in solution and the frequency of the light radiated. The concentration of dye can be adjusted, depending on the dye, so that the penetrating light can basically be absorbed to an extent of over 90% absorbance within 0.1 mm above the surface.
  • the surface-bound complex generated in steps (a) to (d) of said method is excited with an evanescence field of a light source, the fluorescence emitted from said complex is measured, and the human antibodies against the HPAs of interest are detected based on the measured emitted fluorescence, wherein a positive fluorescence signal indicates the presence of said complex and, thus, the presence of human antibodies directed against the HPAs of interest.
  • the term "light source” as used herein is not specifically restricted and includes any light source which is suited to create an evanescence field and excite the fluorophor bound to the antibody of step (d).
  • monochromatic light may be used as the light source.
  • Light should be used that has a wavelength that preferably does not interfere with the emission of the fluorophor and preferably intersects with the absorption band of the dye.
  • a laser is especially preferred as a light source, whose light emits a wavelength of 635 nm.
  • the above third method of the present invention is based on a new technology for analysis of biomolecules using the evanescence field excitation of bound fluorophors and measuring directly the binding events in real time as described in the European patents EP 1 079 226 B1 , EP 1 204 856 B1 , and EP 1 371 967 B1 .
  • the functional principle of this evanescence field biosensor is the interaction of a surface-bound analyte with a ligand in solution by a non-covalent interaction.
  • the ligand in solution is attached covalently to a fluorescent molecule.
  • Preferred excitation of the fluorescent molecule is with coherent light such as generated by e.g. a laser diode and then the emitted photons are detected.
  • Suitable fluorophors for this are for example Cy5, Alexa dyes or the light-harvesting protein Allo-phycocyanine (APC).
  • the biochemical reaction takes place in a small well, similar to an ELISA well in form and dimensions with an additional optical entity on the bottom.
  • the biosensor well and its optical bottom part are produced by injection molding of thermoplastic material, like e.g. polystyrene.
  • Major differences between the ELISA method and the evanescence biosensor methods are the labels of the ligand in solution.
  • the label is an enzyme and for the evanescence technology the ligand is labeled with a fluorescent molecule. Measurement of the bound fluorophor, i.e.
  • the fluorescing ligand in solution binding to the analyte immobilized on the evanescent surface is achieved by specific excitation of the bound fluorescently labeled ligand using the evanescence field excitation principle.
  • Selective excitation of the bound fluorophor occurs by an evanescence field of light using an optical construction resulting in a specific excitation of an approximately 200 nm thick layer of liquid located at the bottom of the well and not exciting the fluorescently labeled ligand in excess present in the solution above the binding surface. Only fluorescently labeled ligands residing in the evanescent field are excited and emit photons. This method allows the observation of a binding reaction of the soluble ligand with the immobilized ligand in real time.
  • the evanescence biosensor allows to perform in vitro diagnostic assays in short time.
  • the complex and costly instrumentation of ELISA automates or for bead based immune assays are neither required nor necessary when using the evanescence biosensor for diagnostic applications.
  • the present invention relates to a third diagnostic test device for carrying out the above third method according to the present invention, comprising at least one surface having at least the antibody of step (b) bound thereto.
  • the surface, the antibody of step (b), and the fluorescently labeled antibody of step (d) are as defined above. Further, the definitions given above apply also to this aspect of the present invention.
  • the above third diagnostic test device of the present invention has the form of a cuvette, microtiter plate or test cartridge, preferably being made of glass or a plastic, preferably a plastic, such as polystyrene, polypropylene, polyethylene, polyethylene terephthalate, polycycloolefin, polyacrylnitrile, polymethylmethacrylate and/or mixtures and blends of these plastics.
  • a plastic such as polystyrene, polypropylene, polyethylene, polyethylene terephthalate, polycycloolefin, polyacrylnitrile, polymethylmethacrylate and/or mixtures and blends of these plastics.
  • any plastic that basically absorbs no light in the visible range is suitable.
  • the plastic can also be dyed light blue, for example, in order to filter out an emission caused by scatter light.
  • Plastic cuvettes, microtiter plates and test cartridges can be obtained inexpensively by injection molding and preferably have a reaction volume of 1 to 400 ⁇ l, especially preferred 5 to 200 ⁇ l, and most preferred 10 to 40 ⁇ l.
  • the cuvettes, microtiter plates or test cartridges of the present invention are made in one piece.
  • test cartridge is not specifically restricted and includes any object which may be used to provide a surface on which the antibodies of step (a) are bound and which may be contacted with the respective solutions or reactants.
  • the test cartridge may be a one-way disposable measurement cartridge that contains multiple, fully separated measurement wells, which are pre-conditioned to the specific measurement needs.
  • test cartridge has multiple wells
  • multiple assays can be run in parallel.
  • the present invention relates to a fourth method for the concurrent detection of (i) at least one human platelet alloantigen (HPA) on human platelets contained in a sample, and (ii) human antibodies directed against human platelet alloantigens (HPAs), in a sample, comprising the steps of:
  • HPA-1a evanescence biosensor test is performed by reacting an anti-gpIIbIIIa antibody coated surface (anti-gpIIbIIIa monoclonal antibody RFGP56), one part of EDTA anti-coagulated blood and two parts of a detection mixture containing the anti HPA-1a specific antibody conjugated to Allo-phycocyanin (APC).
  • anti-gpIIbIIIa antibody coated surface anti-gpIIbIIIa monoclonal antibody RFGP56
  • APC Allo-phycocyanin
  • An evanescence biosensor chip is coated with a solution of RFGP56 in PBS. Coating is done by diluting the RFGP56 stock solution to a 10 microgram per milliliter solution in PBS, adding 30 microliters of this solution to each well and incubating for 2 hours at room temperature. The coating solution is then removed, the well is washed 3 times with PBS and finally 50 microliters of blocking solution is added to the well.
  • the blocking solution is a 1 % solution of BSA in PBS and contains 0.25 % Tween20. Blocking is for approximately 1 hour at room temperature and is terminated by removing the blocking solution and adding the sample solution to be measured.
  • One part of EDTA blood was mixed with two parts of a detection buffer containing anti-HPA-1a APC at 7.5 micrograms per milliliter in a PBS buffer supplemented with 4.5% BSA, 3% Sucrose, 15mM EDTA, 0.08% Tween20, 0.9% NP40, 0.75% PEG6000, 1.5% PVPK90, 0.2mg/ml IIR and 0.06% Brilliant Black BN. 25 microliters of the mixture was put in a coated well and fluorescence was measured in real-time over 10 minutes using evanescence biosensor instrument and device described in EP1079226 , EP1204856 , EP1371967 .
  • the increase in measured photons is given as a whole number and is the increase of counted photons within the first 10 minutes of the reaction for one specific well.
  • the increase of photons measured in one well is given as the change of photons from time zero seconds to time 600 seconds as 'delta counts' (dc) with the measuring unit counts per second or abbreviated 'cps'.
  • the photons emitting from one specific well are measured during the biochemical reaction at time intervals, each measurement is for one second, but any value between 10 milliseconds or 20 seconds per measurement point can also be used.
  • the measured photons are plotted in a graph on the y-axis against the time on the x-axis and this procedure is performed for each well individually. Then a linear regression curve is generated by the software of the reader instrument and the average increase of photons per 10 minute observation time is calculated automatically.
  • a dc of 23099 counts per second, cps, the measured photons in one second, means for this specific well the number of photons measured has increased by 23099 cps within the 10 minutes of measurement.
  • the increase in photon over time, dc in cps, is now a measure for the amount of analyte in the sample.
  • a simple HPA-5b typing assay with the evanescence biosensor system according to the present invention is performed by reacting an anti-gpIaIIa antibody coated surface (anti-gpIaIIa monoclonal antibody AK7), one part of ETDA anti-coagulated blood and two parts of a detection mixture containing an anti HPA-5b specific antibody conjugated to Allo-phycocyanin (APC).
  • Methods and buffers were the same as in example 1 for HPA-1a typing.
  • a MAIPA assay has a cellular assay part sensitizing platelets with anti-glycoprotein antibodies and the antibody from human plasma or serum to be detected as sketched in Figure 2A , and a detection part shown in Figure 2B .
  • Platelet (a) with the platelet glycoprotein (b) are reacted with a monoclonal antibody (c) directed against the platelet glycoprotein under examination.
  • a monoclonal antibody (c) directed against the platelet glycoprotein under examination.
  • four reactions for four different glycoproteins are done with monoclonal antibodies against gpIIbIIIa, gpIaIIa, gpIbIX and HLA/beta-2-microglobulin.
  • the human plasma or serum sample to be analyzed (e) is added and binding of the human anti-HPA antibody (d) occurs, leaving behind the serum with a reduced or depleted anti-platelet antibody (f). Excess human plasma is washed off manually. Using a detergent containing lysis buffer, the tri-molecular complex made of glycoprotein specific antibody (c), platelet glycoproteins (b) and human immunoglobulin (d) is solubilized.
  • the detection of the tri-molecular complex (b), (c), (d) is then done in a one-step evanescence assay according to the present invention.
  • An anti-mouse IgG antibody (g) is immobilized at 10 microgram per milliliter as described in Example 1 on the bottom of the biosensor well, excess reagent is washed off followed by a blocking step. To improve stability of the coated antibody, the wells are then washed twice with PBS followed by two washes with a 2% sucrose solution The biosensor well is then air dried and kept dry till use.
  • antibody coated platelets are solubilized with a buffer containing 2% BSA, 0.25% PVP, 10mM Hepes, 0.9% NaCl, 0.5% Triton, 0.09% NaN 3 .
  • the lysate is then supplemented with 0.04% Brilliant Black BN and an anti-human IgG APC conjugate (Jackson) at 5 microgram per milliliter and measured for 10 min in the fluorescence biosensor instrument.
  • the MAIPA assay routinely uses four individual tubes where each tube is supplemented with a platelet glycoprotein specific monoclonal antibody, i.e. tube one uses an anti-gpIIbIIIa antibody, tube two uses an anti-gpIaIIa antibody, tube three uses an anti-gpIbIX antibody and the fourth tube an anti HLA antibody.
  • the end user must perform an antibody screening test with four individual assays.
  • the assay was performed as a single tube antibody screening assay and to a pool of platelets a pool of the four glycoprotein specific monoclonal antibodies was added and the binding analyzed with the evanescence biosensor assay according to the present invention. Methods and buffers were otherwise identical to the ones given in Example 3.
  • a simple HPA-1a antibody assay with the evanescence biosensor system according to the present invention is performed by reacting a platelet coated biosensor surface with an anti HPA-1a monoclonal antibody and after washing away excess unbound anti HPA-1a antibody, detection of the fraction of bound anti HPA-1a is performed with a secondary anti-human IgG APC labeled antibody.
  • Coating of the biosensor with platelets is done by washing platelets 3 times in PBS and then coating washed platelets in PBS at about 150.000 per microliter in PBS for 1 h at room temperature. This is followed by three PBS washes and a hypotonic lysis in 10mM phosphate buffer with 10mM NaCl for 1 h at RT. Then there are three washes with PBS and a partial protease digestion with Papain for 1 h at 37°C (ID-Papain, DiaMed, Cressier, Switzerland) followed by three washes with PBS and then a blocking step with 3% BSA in PBS for 1 h. Wells are washed three times with PBS, two times with 1% sucrose and then air dried after which they are ready-to-use.
  • the binding assay tests various amounts of anti HPA-1a monoclonal antibody diluted in fetal calf serum, FCS, containing 10mM EDTA for 10 min on the biosensor surface, washing the wells three times with PBS and detecting bound anti HPA-1a IgG with anti-human IgG APC (Jackson) IgG at 5 microgram per ml in FCS supplemented with 10mM EDTA. Measurements are as in Example 1 with the evanescence biosensor for 10 min.
  • Fig. 7 The results shown in Fig. 7 are obtained by plotting on the x-axis the concentration of anti-HPA1a antibody and on the y-axis the fluorescence results in fluorescence dc cps as obtained with the evanescence biosensor. Specificity with respect to platelet genotype 1a and 1b is correct. One observes at low concentrations a linear dose response curve which at concentrations above 1 microgram per milliliter of antibody enters a plateau.
  • Immobilization of platelets to the sensor surface can be effected with many different immobilization technologies. Possibilities are for example a direct coating by physical absorption, other possibilities are to coat an anti-platelet surface proteins antibody such as for example anti-gpIIbIIIa clone RFGP56 or to biotinylate whole intact platelets leading to a biotinylation of platelet surface proteins and subsequently binding to an avidin biosensor surface. Dextran coating and covalent coupling or Poly-L-Lysine coatings followed by electrostatics and/or covalent couplings are just examples of technical possibilities in this respect. Other anti-platelet antibodies such as anti-HPA-5b or anti-platelet auto-antibodies can be detected using the same method.
  • Example 5 The performance of the HPA-1a antibody assay described in Example 5 was further evaluated with a small number of human sera. Assay production and test method and buffers were as described in the Example 5.
  • the evanescence biosensor system is performed by reacting a platelet coated biosensor surface with the anti HPA-1a monoclonal antibody and after washing away excess unbound anti HPA-1a antibody detection of the fraction of bound antiHPA-1a with a secondary anti-human IgG APC labeled antibody.
  • the binding assay tested 1% dilutions of six different human plasmas for their ability to bind with platelet coated biosensors coated with HPA1a positive or HPA1a negative platelets.
  • the human plasma samples were four negative human plasma and a positive and a negative control from the Lyon EFS platelet reference laboratory, Lyon France with a MAIPA OD of 0.7 for the positive plasma and ⁇ 0.1 OD for the negative plasma. This OD of 0.1 is the cut-off value for MAIP positivity or 7 times stronger signal than the cut-off value.
  • Figure 8 shows the anti HPA-1a positive serum to react strongly with HPA-1a positive platelets and only with a background reaction to HPA-1a negative platelets. Signal-to-noise ratio is similar to the MAIPA results. The HPA1a negative control sera as well as the other negative sera did not give any reaction above background levels.
  • biosensors were prepared as described above by coating and drying platelets in the wells.
  • the assay was then done by diluting the human plasma labeled M from Example 6 by taking one part plasma in 200 parts of FCS supplemented with 10mM EDTA. Two samples were prepared where the first sample used plasma M and the second sample was spiked with an anti-human HPA-1a antibody. Anti-human IgG APC (Jackson) was added to a final concentration of 20 micrograms per milliliter and the mixture was analyzed with a platelet coated biosensor. Three different coatings were used for this assay, HPA1a positive platelets, HPA 1a negative platelets and empty uncoated wells as a negative control for biosensor and instrument background. The mixtures were pipetted into the wells and measured as outlined in the above examples for 10 min in a evanescence biosensor instrument and results were recorded.
  • Figure 9 shows a signal only for the HPA1a+ platelets coated biosensor using spiked plasma M whereas the unspiked plasma M gave a negative result.
  • HPA1a negative platelet biosensor and the biosensor alone resulted only in background signal.
  • a one-step double antigen antibody assay for toxoplasmose is done by growing toxoplasma in cell culture and purifying the antigen from the culture by repeated sonication and centrifugation steps (DiaMed Eurogen, Turnhout, Belgium). The antigen is in the form of particular matter and used as it is. One aliquot is used to coat the biosensor chip at 10 microgram per milliliter. A second aliquot is labeled with APC as described.
  • test is done by taking two parts of anti-toxoplasmose IgG standard and mixing with one part of a threefold concentrated detection mix with Tris-buffered 1% casein, 3% BSA and 0.9% Tween 20 and 10 microgram per milliliter toxoplasmose antigen-APC. This mixture is transferred to a toxoplasmose antigen-coated well and measured. Results are shown in Fig. 10 .
EP13002263.5A 2013-04-26 2013-04-26 Typage allo-antigène plaquettaire et tests d'anticorps plaquettaire Not-in-force EP2796880B1 (fr)

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ES14001772.4T ES2657236T3 (es) 2013-04-26 2013-04-26 Tipificaciones de aloantígenos plaquetarios y pruebas de anticuerpos plaquetarios
DK14001772.4T DK2796881T3 (en) 2013-04-26 2013-04-26 Platelet allogeneic antigen type and platelet antibody test.
DK13002263.5T DK2796880T3 (en) 2013-04-26 2013-04-26 Platelet allogeneic antigen determination and platelet antibody assays
ES13002263.5T ES2610731T3 (es) 2013-04-26 2013-04-26 Tipificaciones de aloantígenos plaquetarios y pruebas de anticuerpos plaquetarios
EP13002263.5A EP2796880B1 (fr) 2013-04-26 2013-04-26 Typage allo-antigène plaquettaire et tests d'anticorps plaquettaire
EP14001772.4A EP2796881B1 (fr) 2013-04-26 2013-04-26 Typage allo-antigène plaquettaire et tests d'anticorps plaquettaires
NO14001772A NO2796881T3 (fr) 2013-04-26 2013-04-26
PCT/EP2014/001110 WO2014173546A2 (fr) 2013-04-26 2014-04-25 Typage d'allo-antigènes plaquettaires et tests d'anticorps plaquettaires
JP2016509327A JP2016524691A (ja) 2013-04-26 2014-04-25 血小板同種抗原タイピング及び血小板抗体試験
US14/787,046 US20160077089A1 (en) 2013-04-26 2014-04-25 Platelet Allo-Antigen Typing And Platelet Antibody Tests

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CN106950385A (zh) * 2017-05-23 2017-07-14 北京乐普医疗科技有限责任公司 一种血小板抗体检测试剂盒及其使用方法
CN114467028A (zh) * 2019-08-06 2022-05-10 马格雷股份有限公司 测量复合物溶液中分析物的结合动力学的系统和方法

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NO2796881T3 (fr) 2018-03-31
US20160077089A1 (en) 2016-03-17
ES2610731T3 (es) 2017-05-03
ES2657236T3 (es) 2018-03-02
EP2796880B1 (fr) 2016-10-26
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EP2796881A1 (fr) 2014-10-29
DK2796881T3 (en) 2018-01-02

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